The BANDIT trial found that baricitinib, an oral Janus kinase inhibitor, preserves beta cell function in young people with recent-onset type 1 diabetes (T1D). These findings were presented at EASD 2025, highlighting the potential of oral therapy to support residual insulin production in early T1D. Ninety-one participants within 100 days of diagnosis were randomized 2:1 to baricitinib 4 mg daily or placebo for 48 weeks, with follow-up at weeks 72 and 96. Primary and secondary outcomes included meal-stimulated C-peptide, insulin requirements, and continuous glucose monitoring (CGM) metrics.

At week 48, baricitinib significantly improved C-peptide levels compared to placebo (0.65 vs 0.43 nmol/L/min, p=0.001), alongside lower insulin requirements and better CGM measures. After treatment cessation, C-peptide levels declined (week 72: 0.49 vs 0.36, p=0.015; week 96: no significant difference), with corresponding deterioration in insulin needs and glucose metrics. Quantitative response scores identified 75% of baricitinib participants as responders at week 48 versus 55% with placebo (p=0.0154). No baseline factors predicted response, and adherence did not differentiate responders. No new safety concerns arose during follow-up.

These results support baricitinib as a safe, oral therapy for preserving beta cell function in early T1D, while demonstrating that continuous therapy may be required to maintain benefits.